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代谢物水平对2型糖尿病和血糖性状的影响:一项孟德尔随机化研究。

Effect of Metabolite Levels on Type 2 Diabetes Mellitus and Glycemic Traits: A Mendelian Randomization Study.

作者信息

Sun Yue, Lu Ya-Ke, Gao Hao-Yu, Yan Yu-Xiang

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China.

Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.

出版信息

J Clin Endocrinol Metab. 2021 Nov 19;106(12):3439-3447. doi: 10.1210/clinem/dgab581.

Abstract

OBJECTIVE

To assess the causal associations of plasma levels of metabolites with type 2 diabetes mellitus (T2DM) and glycemic traits.

METHODS

Two-sample mendelian randomization (MR) was conducted to assess the causal associations. Genetic variants strongly associated with metabolites at genome-wide significance level (P < 5 × 10-8) were selected from public genome-wide association studies, and single-nucleotide polymorphisms of outcomes were obtained from the Diabetes Genetics Replication and Meta-analysis consortium for T2DM and from the Meta-Analyses of Glucose and Insulin-related Traits Consortium for fasting glucose, insulin, and glycated hemoglobin (HbA1c). The Wald ratio and inverse-variance weighted methods were used for analyses, and MR-Egger was used for sensitivity analysis.

RESULTS

The β estimates per 1-SD increase of arachidonic acid (AA) level was 0.16 (95% CI, 0.078-0.242; P < 0.001). Genetic predisposition to higher plasma AA levels were associated with higher fasting glucose levels (β 0.10 [95% CI, 0.064-0.134], P < 0.001), higher HbA1c levels (β 0.04 [95% CI, 0.027-0.061]), and lower fasting insulin levels (β -0.025 [95% CI, -0.047 to -0.002], P = 0.033). Besides, 2-hydroxybutyric acid (2-HBA) might have a positive causal effect on glycemic traits.

CONCLUSIONS

Our findings suggest that AA and 2-HBA may have causal associations on T2DM and glycemic traits. This is beneficial for clarifying the pathogenesis of T2DM, which would be valuable for early identification and prevention for T2DM.

摘要

目的

评估血浆代谢物水平与2型糖尿病(T2DM)及血糖特征之间的因果关联。

方法

采用两样本孟德尔随机化(MR)方法评估因果关联。从公开的全基因组关联研究中选择在全基因组显著性水平(P < 5×10-8)下与代谢物强烈相关的基因变异,并从糖尿病遗传学复制与荟萃分析联盟获取T2DM结局的单核苷酸多态性,从葡萄糖和胰岛素相关性状荟萃分析联盟获取空腹血糖、胰岛素和糖化血红蛋白(HbA1c)的单核苷酸多态性。采用Wald比率和逆方差加权法进行分析,并用MR-Egger进行敏感性分析。

结果

花生四烯酸(AA)水平每增加1个标准差的β估计值为0.16(95%可信区间,0.078 - 0.242;P < 0.001)。血浆AA水平较高的遗传易感性与较高的空腹血糖水平(β 0.10 [95%可信区间,0.064 - 0.134],P < 0.001)、较高的HbA1c水平(β 0.04 [95%可信区间,0.027 - 0.061])以及较低的空腹胰岛素水平(β -0.025 [95%可信区间,-0.047至-0.002],P = 0.033)相关。此外,2-羟基丁酸(2-HBA)可能对血糖特征有正向因果效应。

结论

我们的研究结果表明,AA和2-HBA可能与T2DM及血糖特征存在因果关联。这有助于阐明T2DM的发病机制,对T2DM的早期识别和预防具有重要价值。

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